Signs indicate the direction to follow for measles screening in the parking lot of the Seminole Hospital District across from Wigwam Stadium on February 27, 2025, in Seminole, Texas. Jan Sonnenmair/AFP
The global resurgence of measles since 2023 has raised concerns in Lebanon. Struggling with a series of crises since 2019, the country is "in danger if the population does not recognize the importance of vaccinating their children," warned Dr. Randa Hamadeh, director of primary health care at the Health Ministry.
With measles — a highly contagious and potentially fatal infectious disease — posing an increasing threat, the World Health Organization (WHO) and Lebanon’s Health Ministry are urging the immediate vaccination of children, especially as immunization rates remain inadequate.
"Lebanon is an endemic country for measles," emphasized Dr. Gerard Wakim, founding president of the pediatrics department at LAU-MCRH Hospital (Lebanese Americal University Medical Center–Rizk Hospital) and adjunct clinical professor.
The country is open to the movement of Syrian refugees, many of whom are children who remain unvaccinated due to the war. Lebanon has also witnessed internal population movements since the outbreak of fighting between Israel and Hezbollah on Oct. 8, 2023, despite a cease-fire that took effect on Nov. 27, 2024.
"The displaced live in precarious sanitary conditions," Hamadeh said, citing "significant risks of contagion."
"Measles is highly contagious, with each confirmed case potentially contaminating up to 18 people," Wakim added.
Around 80 cases of measles were confirmed in Lebanon in 2024, according to WHO figures. "With four million people, it’s not huge, but the epidemic risk is high since displaced children are weakened by hygiene, food and water restrictions," the pediatrician said.
Officials have also pointed to a "dramatic decline" in national measles vaccination coverage. "The estimated vaccination rate in Lebanon has dropped to 53 percent," said Dr. Alissar Rady, head of the technical team at WHO-Lebanon — far below the WHO’s recommended 93 percent and the figures reported by Lebanese authorities.
"Before COVID-19, Lebanon had reached a vaccination rate of 96 percent for measles and 98 percent for polio," Hamadeh noted. "But since then, alongside national crises, child vaccinations have dropped to 68 percent, similar to many countries, as parents forget to vaccinate their children against childhood diseases," she said, acknowledging that the current rate remains "insufficient."
As part of a prevention campaign in December 2024, the Health Ministry vaccinated all children ages 0 to 10 arriving from Syria, among others, for measles and polio. “The vaccination rate has risen to 84 percent,” the official said.
The global surge in measles cases is also a growing concern. In 2023, nearly 10.3 million measles cases were reported by the WHO and the U.S. Centers for Disease Control and Prevention (CDC) — a 20 percent increase from 2022. During the same period, measles-related deaths were estimated at 107,500, primarily among unvaccinated or under-vaccinated children under age 5, according to the WHO.
Of particular concern is the rising number of cases in Europe and the United States. In France, for instance, cases doubled in 2024 to reach 127,000. The country had already recorded 28 measles-related deaths in 2023.
In the United States — where measles was declared eradicated in 2000 thanks to widespread vaccination — the CDC confirmed 712 cases between Jan. 1 and April 10, 2025. Among them were two confirmed deaths, with a third under investigation. All involved unvaccinated individuals. More than a third of the cases were reported in Texas, within the Mennonite community, an evangelical Christian group known for their "anti-vax" stance.
Robert F. Kennedy Jr., a vaccine skeptic and health minister of the current Trump administration, has faced criticism for not taking stronger action against the measles outbreak.
A very high fever followed by a rash...
"Measles is a severe disease that affects young children and, more rarely, adults — usually during an epidemic. It presents with a very high fever, over 40°C, accompanied by a widespread rash after a few days," Wakim explained. Other symptoms may include cold-like symptoms, coughing, and infections of the eyes, ears, and throat.
While the illness is often mild, measles can lead to serious complications, including — by order of frequency — diarrhea, acute otitis media, respiratory tract infections, viral or bacterial pneumonia, meningitis, acute post-measles encephalitis (often one to two weeks after the rash) and subacute sclerosing panencephalitis, which may appear on average seven years after the rash, usually in adulthood, listed Rady.
"The child can be permanently disabled from measles, risking blindness and deafness, and in rare cases, complications can lead to death," Hamadeh warned, specifying that the primary causes of death are pneumonia in children and acute encephalitis in adults. She urged parents to seek immediate medical care and pediatricians to report all confirmed or suspected cases to the Health Ministry for serological testing.
"The vaccine is the only way to prevent measles and eradicate the disease," said the WHO-Lebanon representative, stressing that "humans are the only reservoir for the virus."
"Have your children vaccinated against measles without delay. The vaccine is available free in all primary health centers, mobile clinics, and from pediatricians," urged the Health Ministry’s primary health care official.
While children in Western countries typically receive two doses of the vaccine, Lebanon’s Health Ministry recommends three doses — at 9 months, 1 year and 18 months — administered as part of the MMR [measles, mumps, and rubella] vaccine.
This article was originally published in French in L'Orient-Le Jour.
